How it works

Effectiveness to prevent pregnancy

Diaphragm (with spermicide): 94% with correct and consistent use, 88% as commonly used

Spermicide (alone): 82% with correct and consistent use, 72% as commonly used

Comments

Diaphragms and cervical caps are generally to be used with spermicide.

Diaphragms / Cervical Cap

Women with conditions that make pregnancy an unacceptable risk should be advised that barrier methods for pregnancy prevention may not be appropriate for those who cannot use them consistently and correctly because of their relatively higher typical-use failure rates.

MEC categories for contraceptive eligibility

Category 1

A condition for which there is no restriction for the use of the contraceptive method

Category 2

A condition where the advantages of using the method generally outweigh the theoretical or proven risks

Category 3

A condition where the theoretical or proven risks usually outweigh the advantages of using the method

Category 4

A condition which represents an unacceptable health risk if the contraceptive method is used

Explanation of A, C, D and S categories

There is no medical reason to deny sterilization to a person with this condition.

C = caution

The procedure is normally conducted in a routine setting, but with extra preparation and precautions.

D = delay

The procedure is delayed until the condition is evaluated and/or corrected. Alternative temporary methods of contraception should be provided.

S = special

The procedure should be undertaken in a setting with an experienced surgeon and staff, equipment needed to provide general anaesthesia, and other back-up medical support. For these conditions, the capacity to decide on the most appropriate procedure and anaesthesia regimen is also needed. Alternative temporary methods of contraception should be provided if referral is required or there is otherwise any delay.

Other:

No other conditions were selected using the "Women’s characteristics" filters.

Adolescents

Category

Clarifications/Special considerations

Adolescents

1

Special consideration: Adolescents In general, adolescents are eligible to use any method of contraception and must have access to a variety of contraceptive choices.Read More

Adolescents

Special consideration:
Adolescents
Special consideration:
Adolescents
In general, adolescents are eligible to use any method of contraception and must have access to a variety of contraceptive choices. Age alone does not constitute a medical reason for denying any method to adolescents. While some concerns have been expressed regarding the use of certain contraceptive methods in adolescents (e.g. the use of progestogen-only injectables by those below 18 years), these concerns must be balanced against the advantages of avoiding pregnancy.

It is clear that many of the same eligibility criteria that apply to older clients apply to young people. However, some conditions (e.g. cardiovascular disorders) that may limit use of some methods in older women do not generally affect young people since these conditions are rare in this age group. Social and behavioural issues should be important considerations in the choice of contraceptive methods by adolescents.

For example, in some settings, adolescents are also at increased risk for STIs, including HIV. While adolescents may choose to use any one of the contraceptive methods available in their communities, in some cases, using methods that do not require a daily regimen may be more appropriate. Adolescents, married or unmarried, have also been shown to be less tolerant of side-effects and therefore have high discontinuation rates.

Method choice may also be influenced by factors such as sporadic patterns of intercourse and the need to conceal sexual activity and contraceptive use. For instance, sexually active adolescents who are unmarried have very different needs from those who are married and want to postpone, space or limit pregnancy. Expanding the number of method choices offered can lead to improved satisfaction, increased acceptance and increased prevalence of contraceptive use.

Proper education and counselling both before and at the time of method selection can help adolescents address their specific problems and make informed and voluntary decisions. Every effort should be made to prevent service and method cost from limiting the options available.